Abstract
OBJECTIVE To ascertain the patient's perspective on dermatologic care providedby primary care providers (PCPs) or dermatologists. DESIGN Cross-sectional survey of patients drawn from primary care and dermatologyclinics. SETTING Academic Veterans Affairs medical center. PATIENTS Convenience sample of patients in either a primary care or a dermatologyclinic. INTERVENTION Survey questionnaire. MAIN OUTCOME MEASURES Patients' confidence in having their skin problems cared for by PCPsand dermatologists and satisfaction with previous care rendered. RESULTS A total of 137 patients in the primary care clinic (group 1) and 100patients in the dermatology clinic (group 2) participated. Patients (N = 237)expressed confidence in their PCP's ability to treat rashes (62%), diagnoseskin cancer (65%), perform skin biopsies (60%), "freeze" lesions with liquidnitrogen (50%), and perform cutaneous surgery (46%). Group 2 patients weresignificantly less likely to have confidence in their PCP than group 1 patientsfor all measures other than the use of liquid nitrogen. High levels of confidencewere expressed in a dermatologist's ability for all 5 measures: 92%, 91%,92%, 83%, and 85%, respectively. Patients were more confident in dermatologists'abilities to perform these procedures compared with PCPs (P<.001 for all comparisons). Of patients previously treated forskin disorders, there was a high rate of satisfaction with the treatment renderedby PCPs (81% for group 1 and 75% for group 2) and by dermatologists (92% forgroup 1 and 90% for group 2). However, patient satisfaction was higher fordermatology vs primary care for the treatment of skin disease (P<.001). Direct access to dermatologists was preferred. CONCLUSIONS Although patients have confidence in their PCP to care for their skindisease, they have greater confidence in the care provided by dermatologists.Among patients previously treated for skin disease, satisfaction was higherwith care rendered by dermatologists vs PCPs. Most patients prefer directaccess to dermatologists should they develop a skin problem.-->
